HomeMy WebLinkAbout04-07-14 (3) BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX I
INHERITANCE TAX DIVISION APPRAISEMENT ALLONANCE OR DISALLOWANCE pennsyLvarna
Pa Box 280601 OF DEDUCTION AND ASSESSMENT OF TAX ON
HARRISBURG, PA 17128-0601 SECURITY ACCOUNTS HELD IN DEPARTMENT OF REVENUE
BENEFICIARY FORM xev-sue,.♦FP "am,
DATE 04-07-2014
ESTATE OF GODFREY JUDITH A
DATE OF DEATH 06-19-2013
FILE NUMBER 21 13-0710
COUNTY CUMBERLAND
SSN/DC
DEBRA J MAUGANS ACN 13504061
28 BRENTWOOD RD APPEAL BY DATE: 06-06-2014
CAMP HILL PA 17011-2505 (See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS 4--_ - -- - - -- - --' - - - -- - --- - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - -
REV-1548A AFP C12-13)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS
AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM
DATE: 04-07-2014
ESTATE OF:GODFREY JUDITH A DATE OF DEATH- 06-19-2013 COUNTY: CUMBERLAND
FILE NO. : 21 13-0710 S.S/D.C. NO. : ACN: 13504061
TAX RETURN WAS: (X) ACCEPTED AS FILED ( )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: AMERIPRISE ACCOUNT NO. : 16432906
TYPE OF ASSET: C I SECURITIES C X SECURITY ACC C ) STOCK C ) BONDS
DOD Valuation 59,904.71 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 0.500 YOUR ACCOUNT, "EMIT TINE
Amount Subject to Tax 29,952.36 UPPERCPORTION TFtYS rdIOTICE
Debts and Deductions - .00 WITH Y.OU& TAX P$YMV20 THE
Taxable Amount 29,952.36 REGIST,%2::kbF WIL3a ANTE i
Tax Rata X .045 ABOVE IADB,R MAKE AHRK
Tax Due 1 .347.86 OR MONT'�DRd)ER "YABt]EI�fO:
"REGIS'! R/?O WILLS, CAGI*T.'
TAX CREDITS: .-V) -n
PAYMENT RECEIPT DISCOUNT C+) G7 -st
AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-7 G r,, Frn yy
In . c
03-05-2014 CD018848 .00 1>347v rN -q86 il ., .
> CLS
TOTAL TAX PAYMENT 1,347.86
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
• IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. +
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.